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21 April 2011

Off with that 'turkey neck'

An under-the-skin plastic sling can provide long-term improvement for the sagging neckline commonly known as turkey neck.

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An under-the-skin plastic sling can provide long-term improvement for the sagging neckline commonly known as turkey neck.

The sling, running from earlobe to earlobe, got a nod of approval from better than 90% of patients who lived with it for three years or more, says a report by Drs Wallace Dyer II and Arvind Prabhat in the November/December issue of the Archives of Facial Plastic Surgery.

And the surgeon can go in months or years later to tighten the sling if necessary, adds Prabhat. He began working on the sling technique as a fellow at Emory University School of Medicine in the US under the supervision of Dyer, who pioneered the technique. Prabhat now is in private practice in New Jersey.

How it works
This is a new technique that builds on existing techniques such as removal of fat and tightening of the skin, says Prabhat. It can be done in combination with a face-lift and plastic surgery methods such as liposuction, he says.

The plastic is Gore-Tex, a material widely used in medicine as well as in clothing. Using a thin strip of it as a sling can overcome the need for recurrent surgical operations needed because the skin of the neck begins to sag and become wrinkled over time, Prabhat says.

The sling is inserted using local anaesthesia. The recipients take antibiotics daily for a week after the procedure, but two of the 100 patients described in the report had infections that led to removal of the sling. Two patients had swelling caused by an accumulation of fluid that had to be drained for more than a week.

Simple and effective
Other techniques to improve appearance of the neck almost inevitably begin to lose their effect over time, Prabhat says. That happened with nine of the patients who got the sling, so Prabhat did a tightening operation, an average of 14 months after the initial procedure.

It's a simple procedure, he says. You go in behind the ear, find the band and tighten it. It takes about 20 minutes.

It's noteworthy that the sling recipients in the study were followed for at least three years, Prabhat says. Most studies have just a one-year follow-up, he says.

Sling insertion is not difficult to learn, Prabhat says. Any surgeon who has the ability to do a neck lift and face-lift can add the technique to the repertoire, he says.

Reversing signs of ageing
The sling has the potential to significantly improve our ability to reverse certain signs of ageing in the neck, says Dr Keith LaFerriere, director of the Facial Plastic Surgery Center in Missouri, who wrote an editorial accompanying the study.

Inflammation is a possible problem because you're using a plastic substance where we don't usually use it, LaFerriere says. But Gore-Tex usually causes inflammation only when it is placed close to the surface of the skin, and the sling is implanted deep enough to avoid that problem, he says. - (HealthDayNews)

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